Kuphulika kwa Clavicle ndi chimodzi mwazowonongeka kwambiri, zomwe zimawerengera 2.6% -4% ya fractures zonse.Chifukwa cha mawonekedwe a anatomical a midshaft ya clavicle, fractures yapakati imakhala yofala kwambiri, yomwe imawerengera 69% ya fractures ya clavicle, pamene fractures ya lateral ndi yapakatikati ya akaunti ya clavicle ndi 28% ndi 3% motsatira.
Monga mtundu wachilendo wa fracture, mosiyana ndi midshaft clavicle fractures yomwe imayamba chifukwa cha kuvulala kwapaphewa kapena kukakamiza kutuluka kuchokera kumtunda wapamwamba kuvulala kolemera, kuphulika kwapakati pakatikati pa clavicle nthawi zambiri kumagwirizanitsidwa ndi kuvulala kangapo.M'mbuyomu, njira yochizira fractures ya kumapeto kwapakati pa clavicle nthawi zambiri imakhala yokhazikika.Komabe, kafukufuku wasonyeza kuti 14% ya odwala omwe ali ndi fractures yapakatikati atha kukhala ndi zizindikiro zopanda pake.Chifukwa chake, m'zaka zaposachedwa, akatswiri ochulukirachulukira adatsamira chithandizo chamankhwala opangira ma fractures apakati omwe amakhudza mgwirizano wa sternoclavicular.Komabe, zidutswa zapakatikati za clavicular nthawi zambiri zimakhala zazing'ono, ndipo pali zoletsa pakukonza pogwiritsa ntchito mbale ndi zomangira.Kupanikizika kwapang'onopang'ono kumakhalabe vuto lalikulu kwa madokotala ochita opaleshoni ya mafupa ponena za kukhazikika bwino kwa fracture ndi kupewa kulephera kukonza.
I.Distal Clavicle LCP Inversion
Mapeto akutali a clavicle amagawana mawonekedwe a anatomical ofanana ndi ma proximal end, onse okhala ndi maziko otakata.Kumapeto kwa mbale ya clavicle locking compression plate (LCP) imakhala ndi mabowo angapo otsekera zotsekera, zomwe zimalola kukonza bwino kwa chidutswa cha distal.
Poganizira za kufanana kwapangidwe pakati pa ziwirizi, akatswiri ena ayika mbale yachitsulo chopingasa pa ngodya ya 180 ° kumapeto kwa clavicle.Afupikitsanso gawo lomwe poyamba linagwiritsidwa ntchito kuti akhazikitse mapeto a distal a clavicle ndipo adapeza kuti implant yamkati imagwirizana bwino popanda kufunikira kopanga.
Kuyika malekezero akutali a clavicle pamalo otembenuzidwa ndikuyikonza ndi fupa la mafupa kumbali yapakati yapezeka kuti ikupereka zokwanira zokhutiritsa.
Pankhani ya wodwala wamwamuna wazaka 40 wokhala ndi fracture kumapeto kwapakati pa clavicle yolondola, mbale yachitsulo ya distal clavicle inagwiritsidwa ntchito.Kuwunika kotsatira pambuyo pa miyezi 12 opaleshoniyo inasonyeza zotsatira zabwino za machiritso.
Inverted distal clavicle locking compression plate (LCP) ndi njira yomwe imagwiritsidwa ntchito kwambiri mkati mwachipatala.Ubwino wa njirayi ndikuti chidutswa cha fupa chapakati chimagwiridwa ndi zomangira zingapo, kupereka kukhazikika kotetezeka.Komabe, njira yokonzekera iyi imafunikira chidutswa chokwanira cha mafupa apakati kuti mupeze zotsatira zabwino.Ngati fupa la fupa ndi laling'ono kapena pali intra-articular comminution, mphamvu yokonzekera ikhoza kusokonezeka.
II.Dual Plate Vertical Fixation Technique
Njira yapawiri ya mbale ndi njira yomwe imagwiritsidwa ntchito kwambiri pakupanga fractures zovuta, monga fractures ya distal humerus, fractures fractures of radius ndi ulna, ndi zina zotero.Pamene kukonza kogwira mtima sikungatheke mu ndege imodzi, mbale zachitsulo zokhoma ziwiri zimagwiritsidwa ntchito pokonza zowongoka, ndikupanga dongosolo lokhazikika la ndege ziwiri.Biomechanically, kukhazikika kwa mbale ziwiri kumapereka maubwino amakina kuposa kukonza mbale imodzi.
The chapamwamba fixation mbale
M'munsi fixation mbale ndi kuphatikiza anayi masanjidwe mbale wapawiri
Nthawi yotumiza: Jun-12-2023
